EDITORIAL : THE BANGKOK POST, THAILAND

 

 

Putting money in wrong place

This is scandalous. When the country is facing a serious shortage of physicians and is in dire need of budgetary support to improve the public health system, our military budget, when compared to the size of the economy, is one of the world's highest.

Last week, the Public Health Ministry revealed that the country needs about 40,000 physicians and is still about 10,000 short. According to acting Public Health Minister Jurin Laksanavisit, one-third of the 30,000 physicians are now breaking their backs to serve the majority of the population in the public health system. Another one-third are in universities or other state agencies, and the final third work in the private sector.

According to the World Health Organisation, the acceptable patients per doctor ratio is at 1:5,000. In Thailand it is 1:7,000. The breakdown is even more shocking in the northeastern province of Loei, where the ratio is 1:14,000. In Bangkok it is 1:850.

This shortage of doctors and the resulting heavy workload is one of the reasons for the high incidence of medical error and strained patient-doctor relations.

Of course, producing more physicians alone cannot solve this problem nor lead to the citizens' general well-being. Respect for patients' rights aside, preventive care and such basics as proper hygiene, nutrition, exercise and a toxic-free environment are all crucial. Still, easy and equal access to public health services is indispensable for people's quality of life. And that requires a high investment in both human resources and infrastructure. It is unfortunate that providing people with health security has a lower priority than military might in this country.

After the 2006 coup, which plunged the country into deep political division, the military budget rose by 50%, apparently because the Abhisit government dared not raise its voice. According to economics professor Pasuk Phongpaichit, the military budget accounts for 1.8% of our gross domestic product. This is higher than Germany's, the largest economy in Europe, with a military budget at 1.3% of GDP, and higher than Japan's 1%. When it comes to the soldier per population ratio, it is 7.9:1,000 in the United States and 2.2:1,000 in Japan. In Thailand, it is 10:1,000. Should we feel safe, angry or sad?

A strong political will to contain the military's ferocious appetite for war-toys is sorely needed in order to channel the money to strengthen the public health and welfare system. Sadly, even when election campaigning is in high gear, discussing a military budget cut is not on any political party's agenda.

At the meet-the-media forum co-organised by the Thai Journalists Association and the Thai Broadcast Journalists Association over last weekend, representatives from the Democrat, Pheu Thai, and other political parties were even defensive about the military. All were in agreement that the question of military budget is not about how much, but how it is used.

This is greatly disappointing.

All political parties are now competing to win votes through handout policies. No matter who wins, the need to finance the populist schemes will be huge. With the currently small tax base, the difficulty to push for progressive land and property taxes, and the politicians' reluctance to agitate the military, it is most likely that the financing of populist and mega projects will eat into the budgets for social and welfare benefits. Ordinary citizens will then have to continue suffering from the shortage of doctors, and public health must take a back seat to military might.